Tuesday, 5 February 2013

Nystagmus with a hearing impairment. As he would put it ‘deaf’

Nystagmus with a hearing impairment. As he would put it ‘deaf’

I worked with a young man yesterday who had a problem with the reality that as he read, his head would gradually turn to one side. He had problems reading partly associated with a hearing impairment that had most likely severely restricted his speech development in terms of clarity, sound production. It was thus quite hard to identify in terms of oral reading performance any reading difficulty.
When reading silently his reading performance was much greater but still appeared to be well below his peers.
Talking with him it was clear that there was a nystagmus (eye shaking) as he looked at you.
On the binocular eye tracker this could be seen as he was reading.
The amount of vertical movement in the graphs is a measure of the amount of muscular effort involved in collecting the visual data.
The flat steps in the fluent reader are the periods of time that the eye is actually collecting information about the words and ultimately the ideas being transmitted.
With the person with the nystagmus, only when the eye is moving slowly at the top and bottom of the loop can the visual data be collected.

The reading speed for the upper graph was less than 100 words per minute and for the lower graph the fluent reader it was over 400 words per minute.
The student with nystagmus was putting too much demand on his memory system just to capture the visual data for effective intonation, prosody and ultimately comprehension.
You could not link the reading speed to intelligence in this extreme example. I have met a few people with a nystagmus who were very academically successful; my thoughts then go to the question of just how successful they might have been if they did not have the nystagmus!
When he read from a screen using a lower light intensity and used neutral density (grey) wrap around glasses
His eye oscillation reduced to 50%.
His head no longer turned to one side.
His reading appeared to improve by sitting on a computer chair which gave him ease of upper body movement.  The need to not be static seems important for many people with reading issues.

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